FALLS

Question 0

Management of falls?

Answer 0

Pharm
Treat underlying cause
Review medications
Taper sedatives

Non pharm
Reduce alcohol intake
Rehabilitation - OT personal trainer
Enhance mobility - use cane walker rails, improve vision/environment

Question 1

Why are falls important?

Answer 1

One of the leading causes of morbidity and mortality.
Fear of falling can restrict activity
Suggest underlying disease
Common lead to serious injury (hip fractures)

Question 2

Causes of falls?

Answer 2

Poor eyesight, difficult environment (lighting, rugs, poor footwear) Medications - polypharmacy esp sedatives, antipsychotics, anti hypertensives
Cognitive impairment - dementia
Poor balance or gait - stroke, Parkinson’s, neuropathy
Dehydration

Question 3

What is the frailty criteria? Why is it relevant?

Answer 3

Syndrome classified by loss of function, strength and physiological reserve.

Cardiovascular health study index
 3 of 5:
- wt loss > 5% over last year
- exhaustion 
- weakness 
- slow walking speed 
- decreased physical activity 

Relevant in terms of

Question 4

What is top shelf syndrome?

Answer 4

Subclavian steel syndrome

Narrowing of the subclavian artery causing retrograde blood from ICA.

Blood to subclavian is said to be stolen from brain.

Question 5

What is carotid sinus syndrome?

Answer 5

Sudden drop in BP. And consciousness when applying pressure to the neck. Commonly occurs to people while shaving.